World Mental Health Day: All about mental disorders

Liji Varghese

World Mental Health Day, celebrated annually on October 10, is a global awareness program about various mental health issues.

Mental disorder is a physiological condition that can cause distress and is reflected through a person’s behavior. Here is a list of mental disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (manual used by clinicians and psychiatrists to diagnose psychiatric illnesses):

ANXIETY DISORDERS

Anxiety disorder is a blanket term used for various psychiatric disorder characterized by excessive and abnormal fear, worry, apprehension and anxiety.

Types of anxiety disorders include:

i) Generalized anxiety disorder (GAD): A chronic disorder, GAD most commonly affects elderly people as compared to others. It is characterized by long-lasting anxiety which may or may not be focused on any one object or situation.
ii) Phobias: Phobia is the sense of endangerment or fear of harm from an object or situation. Phobic disorder affects 5% to 12% of the world population.
iii) Panic disorder: People suffering from panic disorder experience brief attack of extreme fear leading to rapid breathing and increased heart rates.
iv) Post-traumatic stress disorder (PTSD): People who have been in extreme situations like combat, hostage situation, rape, child abuse etc. are more prone to developing PTSD.
v) Childhood anxiety disorders: Triggered due to biological and psychological factors, childhood anxiety disorder affects about 13 of every 100 children with girls being at a higher risk compared to boys.
vi) Obsessive–compulsive disorder (OCD): As the name suggests OCD is characterized by the compulsion to do specific acts repeatedly.

Common symptoms include:

a) Feelings of anxiety, anger and fear
b) Rapid heartbeat, raised blood pressure, trouble breathing, dizziness and nausea
c) Increased sweating from the hands, feet and axillae
d) Hypervigilance, flashbacks, avoidant behaviors in case of PTSD

MOOD DISORDERS

Mood disorders is the term used for a person`s mental state characterized by extreme highs and lows in mood. Bipolar disorder and Major depressive disorder are two broadly recognized categories of mood disorders.

i) Major Depressive Disorder (MDD): Also known as clinical depression, major depression or unipolar depression, MDD is the state in which the affected person loses interest in routine activities and appears depressed almost through out the day. Though most of us go through the phase of feeling down and out one time or the other in our lifetime, it is termed a clinical depression only when the symptoms persist for weeks or longer and interferes with one’s routine. Depression affects men, women and infants equally and can appear at a young age of just 6 months.

Symptoms:

a) Depressed mood through out the day continuing into weeks and longer
b) Withdrawal symptoms marked by prolonged fatigue, loss of energy and diminishing interest in routine activities
c) Dramatic change in appetite marked by significant weight loss or weight gain
d) Insomnia or hypersomnia i.e. trouble sleeping or too much of sleep
e) Lack of concentration
f) Feeling of worthlessness, self-hate, guilt with recurrent suicidal thought
g) Instance of hallucinations, delusions


ii) Bipolar disorder (BD): Characterized by alternating periods of mania and depression, BD can set in at the age of 15-25 affecting men and women equally. Due to the extreme and rapid mood swings between mania and depression, BD was formerly known as manic depression.

Classed into three categories – Bipolar I (cycle between mania and depression), Bipolar II (cycles between hypomania and depression), cyclothymia cycles (episodes of recurrent hypomanic and dysthymic); the risk of BD is higher in people having a family history.

Manic and depressed phase of bipolar disorder include following symptoms:

a) Lack of self control, poor temper, reckless behaviour
b) Trouble sleeping, eating
c) Easily distracted, difficulty in remembering, making decisions
d) May show hyperactivity, prolonged fatigue
e) Poor judgement, agitated and irritated
f) Withdrawal into seclusion accompanied by suicidal thoughts

COGNITIVE DISORDERS:

Cognitive Disorders involves trouble with memory, perception, and problem solving. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) describes it as disorders with “a significant impairment of cognition or memory that represents a marked deterioration from a previous level of function”.

Three main areas outlined by the DSM-IV-TR of cognitive disorders are:

i) Delirium: People diagnosed with this condition tend to find it difficult to process new information. Delirium can be caused due to pre-existing medical condition. Symptoms include shift in attention, mood swings, violent or unordinary behaviors, and hallucination.
ii) Dementia: Dementia is the loss of brain function that erases part of patient’s memory due to conditions like brain trauma, stroke, heart diseases and genetics.
iii) Amnesia: Patients diagnosed with amnesia often find it difficult retaining long term memories.

PSYCHOTIC DISORDERS

Psychotic Disorders is a mental state that involves a loss of contact with reality. Schizophrenia, the condition in which the patient is unable to distinguish between what is real and what is not, is one of the most well-known disorders in this category.

Though symptoms vary from patient to patient major signs include:

a) Hallucination and delusion
b) Extreme mood swings, loss of interest in routine activities
c) Confused thinking and disorganized speech
d) Have detached, cold attitude
e) Behave strange, rather dangerously

DISSOCIATIVE DISORDERS

Primarily caused due to psychological trauma, a person diagnosed with dissociative disorders has trouble recalling past and can exhibit more than one distinct personality.

DSM-IV-TR list five types of dissociative disorders-

i) Dissociative identity disorder, formerly called Multiple Personality Disorder, is a state in which a person exhibits more than one distinct personalities
ii) Depersonalization disorder in which one feels detached from self or surrounding
iii) Dissociative amnesia is characterized by retrospectively reported memory gaps
iv) Dissociative fugue is characterized by reversible amnesia for personal identity
v) Dissociative disorder not otherwise specified

DEVELOPMENTAL DISORDERS

The condition which interferes with the normal development of cognitive skills during some stage or the other of a child’s development is termed as development disorder. Children diagnosed with development disorder may show signs of mental retardation, learning disabilities, communication and attention-deficit hyperactivity disorder. Autism and dyslexia are examples of development disorder.

Symptoms include:

a) Impairments in social interactions, communication
b) Repetitive or restricted patterns of interest or behaviors
c) Inattentiveness, impulsiveness, and hyperactivity or poor control over actions
d) Face academic problems
e) Exhibit poor interpersonal relationships


SOMATOFORM DISORDERS

Patient suffering from samatoform disorder mimic symptoms of real diseases without actually showing any physical signs of illness. However somatoform disorders is different from factitious disorders as people suffering from it do not exhibit fake symptoms.

Symptoms include:

a) Constant worrying about one`s health due to lack of physical evidence
b) Stress, anxiety and depression
c) At times symptoms are similar to that of the other illnesses